Smallpox, Propaganda and Fear
by Sara S. DeHart, MSN, Ph.D. February 17, 2003
In recent months considerable debate has centered on the ostensible need for and safety of vaccinating US civilian and military personnel as protection against a smallpox epidemic. As in any debate, there are numerous voices expressing diverse perspectives: academics, lobbyists, governmental spokespersons, and communicable disease experts. Also, as in any broad debate, it is sometimes difficult to separate facts from illusion. In the current vaccination debate, politics and special interests are dictating medical and public health policy. This results in poor public health policy and bad medicine.
Because leaders in the Bush Administration took an oath to "preserve, protect and defend the Constitution of the United States," one might conclude that the government would never risk the physical or mental health of its military personnel or the civilian public-at-large for political reasons. After all, one of the stated purposes of government is to maintain public health and safety.
Given that caveat, is it reasonable for Mr. Bush to select a disease and order the dispensing of a vaccine that carries a high risk for serious complications to both the recipient and those with whom they have contact without evidence that the disease is present? The Institute of Medicine has gone on record to urge caution about the high risk of the smallpox vaccine and the vaccination program. Because of the significant number of side effects military and other "volunteers" have experienced in the current round of vaccinations this warning should be taken seriously,
Nonetheless, there is a growing body of evidence that the Bush Administration's ongoing campaign to convince the American public that there is a need for mass inoculation against biological warfare continues unabated. According to Administration officials, a smallpox threat emanates from Iraq and/or the Al Qaeda organization. One might view this campaign as part of the Administration's goal to manipulate public perception and establish a "just cause" foundation for a preemptive war against Iraq. Implied in the call for mass inoculation against smallpox is the assumption that Saddam Hussein has the intention and ability to wage biological warfare against America, the delivery system to get deadly biological agents to American shores and that smallpox is his weapon of choice.
As a political tool, smallpox has everything a propagandist needs to engage in hyperbole and instill fear in an uninformed public. Smallpox is, in fact, a deadly disease that according to the World Health Organization (WHO) was eradicated in 1977. In 1980 WHO recommended that all countries cease vaccinations because of the high risk from the vaccine itself and the low risk of the disease re-emerging spontaneously. The World Health Organization further recommended that all laboratories, except for two designated in the United States and Russia, destroy their stocks of variolla virus. Rumors persist, however, that other sources of the variolla virus exist in unsanctioned laboratories.
This fear has been expanded by the overwhelming volume of smallpox-threat "news" emanating from the corporate media. The timing of this "news" coincides with the Bush administration's campaign to convince the American public that preemptive war against Iraq is a "just cause". The timeline between Mr. Bush's announcement of his preemptive war doctrine in June 2002 and his directive in September for mass inoculations against an external bioterrorism smallpox attack has all the sound and fury of an egregiously orchestrated propaganda blitzkrieg.
Beginning in August 2002, the number of articles published by mainline newspapers increased exponentially. Major news sources in virtually every region of the country published numerous articles on smallpox, its causes, and deadly effects. Importantly, many are now aware of the 30% death-rate that results for those who develop the infection. An ill-informed public, the majority of whom cannot identify their congressional representative, has been inculcated about the danger of biological warfare, in general, and smallpox as a biological weapon, in particular.
If Bush and the neo-conservatives can convince the American people that the threat of biological terrorism is real and that the source of the threat is Iraq, the people will demand to be inoculated and enthusiastically call for Bush to dispatch US armed forces to Iraq. They will ignore the fact that a preemptive war is likely to increase the probability of a guerilla-like, terrorist attack on the U.S.
But before lining up for inoculations, Americans need to be aware of certain facts about the vaccine. First, the serious complications from the smallpox vaccination are not insignificant. The most frequent, serious complication from the smallpox vaccination is encephalitis that is fatal in 25% of the cases and causes neurological damage in 23% of those who develop this brain inflammation. Vaccinia necrosum is a progressive destruction of the skin and other tissues that spreads throughout the body. Eczema vaccinatum is a significant risk if one has ever had eczema or other chronic skin disorders. More rarely, the vaccination results in fatal vaccinia. The risk to persons who are immune-suppressed or have ever had eczema, and who come in contact with a newly vaccinated person, such as a nurse, is life threatening.
Second, consider the curious amendment to the Homeland Security Act enacted by Congress in December 2002. Included in this prototypically fascist legislation was a rider denying legal recourse to anyone who might have a negative side effect from the vaccine. Even though Congress has recently rescinded that provision, supporters of the legislation promise that this issue will be addressed in future amendments to protect the vaccine manufacturers.
Justification for this special-interest protection came from Senate Majority Leader Frist who asserted that protection against possible lawsuits was necessary because the pharmaceutical corporations, Ely Lilly and Wyeth, would not otherwise manufacture vaccines. Senator Frist, one might recall, is a medical doctor by education and, therefore, presented to the public as an objective authority on all matters pertaining to public and private health.
In reality it seems that Senator-Doctor Frist is, in fact, not concerned about the physical health and welfare of the American public as much as he is about the financial health and welfare of the pharmaceutical industry. Consider the millions of dollars that the pharmaceutical industry will make if 200 million Americans line up to be inoculated with a vaccine that is largely untested and has only recently gone into mass production. Wyeth stockpiles comprise the older vaccine inventories and are made from a scarified calf flank that invariably produces microbial contamination. Presumably, these are the vaccines to be used in the current round of vaccinating public health, medical and emergency workers.
It is not surprising that health care professionals designated as part of the "first response" teams are showing great reluctance to accept "voluntary" smallpox vaccinations. The Bush administration sent the first batches of smallpox vaccine to the states on January 21, 2003 to immunize some 500,000 medical volunteers. These teams are to be inoculated so in the event of a biological terrorist attack, they would be protected when they encounter patients infected by smallpox. In itself, this is not a bad plan except for the uneasy feeling among many health care professionals that this action is politically based to further the cause of preemptive war against Iraq.
The prestigious Institute of Medicine issued a cautionary report published in the January 18, 2003 San Francisco Chronicle: "Given this profile of high vaccination risk and possibility of very low to zero benefit, the administration's policy to offer vaccination to public health, medical and emergency workers must be implemented in a most prudent and cautious manner." Not to be distracted by the Institute's report, Dr. Julie Gerberding, Director of Federal Centers for Disease Control and Prevention issued a press briefing stating, in part, that homeland security and national defense concerns dictate that the voluntary vaccination program proceed quickly. She said, "We are, in fact, living in a dangerous world, where a smallpox attack is possible. We need to do what we need to do to get this show on the road". She further said, "We are not going to delay this program because of concerns about compensation."
Even though Dr. Gerberding chooses to ignore the issue of compensation for potentially damaging side effects, the American Nurses Association sent a letter to Mr. Bush expressing grave concerns about who will provide coverage for vaccinated nurses and their families if there are secondary infections or other serious complications. The senate version of the Homeland Security Act specifically mandates that anyone suffering a complication from smallpox vaccination cannot sue the pharmaceutical company, the hospital, or the provider. If anyone is going to sue, they must sue the government directly which is very difficult to do and economically prohibitive for most American citizens.
Dr Gerberding, like Mr. Bush, seems unconcerned about the potentially serious side effects of the smallpox vaccine. Nor has either addressed the larger question of what will be done if a different microorganism emerges as a biological weapon. The smallpox vaccine is not going to protect the US public against any other microorganism, and there are several deadly ones to choose from.
Not since Napoleon Bonaparte ordered the vaccination of his troops in 1805 and French civilians in 1806 has such a comprehensive vaccination program been instituted. A noteworthy difference between Napoleon's program and Bush's executive order is that in Napoleon's time, there was a real threat of a smallpox epidemic. By contrast, Mr. Bush's proclamation is founded on fear that his administration has invented, exploited and perpetuated.
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